Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN JAMES WAGNER, DPT
ActiveETHAN JAMES WAGNER, DPT is a Physical Therapy Assistant healthcare provider located in BENTON, Arkansas. NPI 1104640879 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · BENTON, AR
Registration Details
- NPI Number
- 1104640879
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 11, 2024 (1.7599830041158 yrs)
- Last Updated
- Nov 11, 2024
- License
-
PT5585 (AR)
Practice Information
- Address
-
20320 I 30 # 190BENTON, AR, 720198027Browse AR providers · Browse ZIP 72019
- Phone
- 5015008188
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in BENTON, AR
| Name | Credential | NPI |
|---|---|---|
| RANDALL GREEN | PT | 1457352056 |
| MR. DANIEL B. MYERS JR. | PHYSICAL THERAPIST | 1477546562 |
| MR. RICHARD DALE STEVENS | PT | 1073596086 |
| MS. KATHYRN ELAINE SANDUSKY | MS PT | 1053370700 |
| MRS. KELLI BRYAN WINTERS | MS PT | 1679532444 |
| MR. COREY WAYNE TINKLE | MS PT | 1790744563 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.